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Cervical cancer - medical negligence in diagnosis and treatment

I recently obtained compensation for the family of a woman who died from cervical cancer. She was 32 years old and had a family when she died, less than one year after she was diagnosed. Yet her story is not a one-off.

We have come so far in detecting and treating cervical cancer, yet negligence still occurs – with devastating consequences. What are the types of medical errors made in cervical cancer cases that result in negligence? What kind of injuries can occur if you’ve suffered medical negligence? What can be done to help?

Cervical Cancer: Overview

The cancer occurs in the cervix, the entrance to the womb from the vagina.

It is the most common cancer in women under 35, with approximately 3,000 women diagnosed every year in the UK.

It is almost always caused by the human papillomavirus (HPV). This is a common virus that can be passed through sexual contact. There are different strains of the virus, the majority of which are harmless, however some can cause abnormalities to the cervix leading to cancer.

In the UK a cervical screening service is set out. Women aged between 25 and 49 are invited for cervical smear tests every 3 years. For women aged 50 to 64, they are invited to attend screening every 5 years. The hope is that screening can help detect cancer or abnormalities which could result in cancer before it occurs.

Treatment for cervical cancer depends on how advanced the cancer is and your general health. Usually, treatment includes:

surgery (to remove some or all of your womb)

radiotherapy; and/or

chemotherapy

Quite often a mixture of treatment methods can be used.

Patients can be cured completely if the cancer is diagnosed early and treated properly. However delays and failings in appropriate care can cause the cancer to spread, limiting the patient’s treatment options and reducing their life expectancy.

Once you have been diagnosed, your cancer will be staged – to classify where it is in your body and how advanced it is. This diagram from Jo’s Trust provides an explanation of the stages and what they mean:

The picture does not include stages 4. Stage 4a means that the cancer has spread to other part of the body which are close to the cervix, such as the rectum. Stage 4b means that the cancer has spread to more distant organs, such as your lungs.

The Law: Proving Negligence

Medical mistakes are bound to happen, and not every mistake constitutes negligence. In order for your treatment to be negligent, you must show that:

It was unacceptable and would not have been provided by any other reasonable body of medical practitioners in the UK;

This unacceptable treatment caused you a further injury which you would not have had if your care had been appropriate.

You must be able to prove both of these elements to succeed. For example, you’re unlikely to succeed if you can only show that there was a delay in your diagnosis – but that this made no difference whatsoever to your condition. Or, if you can show that your condition would have been better with different treatment, but that actually the care you received was acceptable and cannot be criticised.

If we can help you with a medical negligence claim, your solicitor will work with you and a team of experts to obtain relevant evidence. Independent medical experts and barristers will be relied upon. Evidence will also be obtained from your medical records and your witness statement, explaining what you recall happening.

Types of Negligence

Negligence in cervical cancer cases can happen before or after you are diagnosed.

Negligence in Diagnosis

Cervical cancer is usually detected in two ways:

when a patient attends their GP and is referred for further assessment, or

when a patient undergoes routine screening and abnormalities are detected.

If you attend your GP with any of the symptoms of cervical cancer, action should be taken. Your GP should take a detailed history from you, checking to see your last cervical smear results, and may need to perform a vaginal examination to look at your cervix. If any abnormalities in your cervix are noted which raise the suspicion of cervical cancer, you should be referred for further assessment within two weeks. This will most likely take place in a hospital’s gynaecology department.

The most common GP failing is when symptoms of cervical cancer are overlooked. Quite often, women who complain of irregular bleeding and/or pain are advised they have menorrhagia (heavy bleeding during their menstrual cycle) or dysmenorrhoea (painful menstruation). They are given tablets which mask these symptoms and can lead to the cancer being missed. A GP may also be negligent if they suspect cervical cancer but fail to refer the patient for assessment within two weeks.

There can also be failings in diagnosis during routine screening. Quite often, abnormalities or cancer are missed and the patient is mistakenly reassured that they are fine. This can sometimes mean that the cancer is then not picked up for another three years, until the next cervical smear test. As catching the cancer early is key to curing it, this can have a devastating impact on the patient’s health. There can also be problems when the cervical smear test is not undertaken properly or when the patient is not informed of their abnormalities.

Negligence in Treatment

Negligence can commonly occur during:

Surgery: when the area that needs to be removed may be completely removed or damage may occur to other organs, such as the ureters or nerves. This can mean that the cancer is not effectively treated or that further treatment is required;

Radiotherapy/Chemotherapy: this must be used only when required and used appropriately, to eradicate the cancer.

Injuries Due to Negligence

If there are failings in diagnosis or treatment, this can cause several injuries to the patient. It’s likely that her cancer will spread – this will mean increased symptoms, a need for more aggressive treatment and an impact on her fertility and life expectancy.

What Can Be Done?

If you’ve suffered injuries due to unacceptable medical failings, you will be able to pursue a medical negligence claim.

The aim of a claim is compensation. This is to try to put you in the position you would have been in had the negligence not happened – as much as it can. You will also receive compensation for any financial losses you incurred because of the negligence, such as loss of earnings, travel and medical expenses and funeral expenses.